Computer-aided learning in the real world of medical education: does the quality of interaction with the computer affect student learning?

BACKGROUND Computerised learning clearly offers exciting potential for improving student learning, either as an aid to or as a replacement for traditional formats, or for the development of innovative approaches. However, rigorous evaluation of the utility of computer-aided learning (CAL) in enhancing student learning can be difficult. Many studies have compared CAL to more traditional learning formats, but there is little evidence to show which style of CAL leads to the best learning outcomes. AIM This study aimed to test the hypothesis that a CAL tutorial, in which the learner actively interacts with the computer, will result in superior learning (ability to apply and retain knowledge) to that obtained in more passive CAL formats. METHODS Third year medical undergraduates at Adelaide University, South Australia were randomly assigned to 4 groups. Following a pretest, only students in the 'didactic', 'problem-based' and 'free text' groups had 2 weeks of free access to a neuroradiology CAL tutorial in their assigned format. Tutorial access was denied to all students 2 weeks before post-testing. Learning was quantified by comparing the post- to pretest scores for each of the 4 groups. RESULTS After active interaction with the computer material, students in the free text group demonstrated a statistically significant improvement in their ability to apply and retain knowledge compared to the control group, but no advantage compared to the didactic group. CONCLUSIONS While users of an interactive CAL tutorial demonstrated significant learning gains compared to non-CAL users, these gains were not superior to those achieved from non-interactive CAL. When evaluating education interventions such as CAL packages, it is important to use a valid assessment tool to measure learning.